Collection and analysis of vital signs

ABSTRACT

A system is disclosed having a storage, a communications module for interacting with a medical measurement device, an analysis controller, and a test module that allows for the testing and evaluating of decision-support algorithms. A method for testing decision-support algorithms is disclosed having the steps of receiving into storage of a ruggedized, compact computer at least one decision-support algorithm; detecting with a communications module the initiation of a vital-sign monitoring session; receiving and storing vital-sign information into storage by the communications module; pushing the stored vital-sign information by an analysis controller to a test module running the stored at least one decision-support algorithm; and providing at least one output from the decision-support algorithm to at least one of a database and a display.

This application is a continuation-in-part of U.S. patent applicationSer. No. 13/204,657 filed Aug. 6, 2011, which claims the benefit of U.S.provisional patent application No. 61/401,179 filed Aug. 6, 2010 andentitled “System for Real-Time Collection and Analysis of Vital Signsand Prediction of Clinical Outcomes,” which are hereby incorporated byreference.

I. FIELD OF THE INVENTION

This invention relates to a system and method for developing, testing,and evaluating decision-support algorithms in a portable unit usingstored data and/or real-life, real time data.

II. BACKGROUND OF THE INVENTION

Typically, decision-support algorithms are incorporated into vital-signmonitors and other medical recording systems. This results in thealgorithms being proprietary to the manufacturer and not facilitatingeasy modification or refinement by end-users and/or testing of newdecision-support algorithms by either the manufacturer or the end-users.

Most of the existing literature discusses research in thedecision-support area that uses retrospective analysis of previouslygathered data to test and refine decision-support systems located onworkstations and/or servers.

III. SUMMARY OF THE INVENTION

The invention provides in at least one embodiment a system for receivingan output from an external source where the system includes: a storage;a communications module for receiving vital-sign data from an externalsource and storing the received data in the storage; an analysiscontroller in communication with the storage, the analysis controllermonitors the storage; a reliability module in communication with theanalysis controller, the analysis controller includes means fordetermining whether the vital-sign data is quality vital-sign data; anda test module in communication with the analysis controller and thestorage, the test module receives information from the storage throughthe analysis controller and stores any output in the storage, and thetest module includes running means for running at least one algorithmloaded into the storage where the at least one algorithm processes atleast a portion of the information provided by the analysis controller.

The invention provides in at least one embodiment a system for receivingvital-sign information from a vital-sign monitor, the system including:a storage having at least one database; a communications module forreceiving vital-sign data from an external source and storing thereceived data in the database of the storage; an analysis controller incommunication with the storage, the analysis controller monitors thestorage; a reliability module in communication with the analysiscontroller, the analysis controller includes means for determiningwhether the vital-sign data is quality vital-sign data; a test module incommunication with the analysis controller and the storage, the testmodule receives information from the storage through the analysiscontroller, and the test module includes running means for running atleast one algorithm loaded into the storage where the at least onealgorithm processes at least a portion of the information provided bythe analysis controller, the running means provides an output insubstantially real time from receipt of vital-sign data by thecommunications module; and a ruggedized, compact housing enclosing thestorage, the communications module, the analysis controller, and thetest module.

The invention provides in at least one embodiment a method for testingdecision-support algorithms where the method includes: receiving intostorage of a ruggedized, compact computer at least one decision-supportalgorithm; detecting with a communications module the initiation of avital-sign monitoring session; receiving and storing vital-signinformation into storage by the communications module; determiningwhether the vital-sign information is quality vital-sign information,when the vital-sign information is not quality then not using thatvital-sign information; pushing the stored quality vital-signinformation by an analysis controller to a test module running thestored at least one decision-support algorithm; and providing at leastone output from the decision-support algorithm to at least one of adatabase and a display.

Given the following enabling description of the drawings, the inventionshould become evident to a person of ordinary skill in the art.

IV. BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is described with reference to the accompanyingdrawings. In the drawings, like reference numbers indicate identical orfunctionally similar elements. The use of shading within the drawings isnot intended as limiting the type of materials that may be used tomanufacture the invention.

FIG. 1 illustrates a block diagram including a data flow according to anembodiment of the invention.

FIG. 2 illustrates a block diagram according to an embodiment of theinvention.

FIG. 3 illustrates an embodiment according to the invention.

FIG. 4 illustrates a flowchart of a method embodiment according to theinvention.

FIG. 5 illustrates a block diagram according to another embodiment ofthe invention.

FIG. 6 illustrates a computer program product and computerimplementation according to an embodiment of the invention.

V. DETAILED DESCRIPTION OF THE DRAWINGS

FIGS. 1-4 illustrate different embodiments and aspects according to theinvention.

In at least one embodiment, the system 100 is compact, which for thisdisclosure is defined as being easily moved and transported, forexample, between a vehicle such as an ambulance or medical evacuationhelicopter to a medical facility with the patient. Compact is furtherdefined as smaller than a laptop and small relative to a vital-signmonitor 190 such as illustrated, for example, in FIG. 3. Compact isfurther defined by being of sufficiently small size to allow for use inthe field away from established medical facilities.

In at least one embodiment, the system is ruggedized, which for thisdisclosure is defined as being able to substantially withstandvibration, shock, temperature, temperature shock, altitude, dropping,rain, dust, and humidity and remain substantially working andoperational for its intended purpose.

In at least one embodiment, the system operates in real time, which forthis disclosure is defined as storing and processing a continuous streamof vital-sign information (or data) as outputted by a vital-sign monitorwhere the processing includes any algorithm 1254 present in the testmodule 125 with substantially minimal lag time (e.g., allows forprocessing time by the algorithm(s) 1254). Examples of vital-signinformation include heart rate, respiratory rate, arterial blood oxygensaturation (SpO₂), systolic and diastolic blood pressures, and meanarterial pressure.

As illustrated in FIG. 1, the flow of data through at least oneembodiment includes a system 100 having a communications module 110, astorage 115, an analysis controller 120, and a test module 125. Thecommunications module 110 is in communication with the storage 115. Theanalysis controller 120 is in communication with the storage 115 and thetest module 125, which in at least one embodiment is in communicationwith the storage 115. As used in this disclosure “in communication”includes physical and wireless connections that are indirect through oneor more additional components (or over a network) or directly betweenthe two components described as being in communication.

FIG. 1 also illustrates an example of how data will flow through atleast one embodiment. The output of the vital-sign monitor (or othermedical monitor or external source) 190 is received by thecommunications module 110 that stores the received data into storage (ormemory) 115. In at least one embodiment, storage 115 includes a databasefor storing the received data. For the purposes of this disclosure, adatabase includes any type of list, data table, relational database, atext file, a comma delimited file, data log file, or a series of datafiles associated with one session. The analysis controller 120 monitorsthe storage 115 for the addition of new data that it will push to thetest module 125. The test module 125 provides an environment in which aloaded algorithm(s) 1254 (illustrated in FIG. 2) operates to produce aresult based on at least a portion of the data pushed by the analysiscontroller 120. The produced result in at least one embodiment isprovided to at least one of the storage 115 including, for example, thedatabase used for the received data or a separate database; a display130; or for transmission to an external device through, for example, awired connection or an antenna 1054 (illustrated in FIG. 3).

FIG. 2 illustrates an embodiment similar to that of FIG. 1 without theflow of data being represented. FIG. 2 illustrates the system asincluding a communications module 110, a storage 115, an analysiscontroller 120, and test module 125.

The communications module 110 maintains the connection with thevital-sign monitor 190 and stores the received data (e.g., vital-signinformation) into storage 115. The communications module 110 in at leastone embodiment transmits a “keep-alive” (or similar) packet (or message)to the vital-sign monitor 190 to maintain the connection and avoidtermination of the connection by the vital-sign monitor 190. Thecommunications module 110 in at least one embodiment traps errors andrecovers from communication errors using, for example, cyclic redundancycheck to determine if corruption is present in the received packet ofinformation. In addition in further embodiments, the communicationsmodule 110 uses a sequential packet number, which in at least oneembodiment cycles through a set of numbers, present at the start of eachpacket to maintain the received packets in order prior to storage 115 ofthe received information, which is useful in a network environment withmultiple paths between the vital-sign monitor and the communicationsmodule. For example, the Welch Allyn Propaq vital-sign monitors producepackets at different frequencies. Numerical data from the vital-signmonitor, such as heart rate, respiratory rate, blood oxygen saturation,and noninvasive systolic, diastolic, and mean blood pressures, areoutputted at a frequency of 1 Hz (once per second). Theelectrocardiogram (ECG), photoplethysmogram (PPG), and impedancepneumogram (IP) are waveforms that are reported at 182 Hz, 91 Hz, and 23Hz, respectively, and in at least one embodiment the packets are sentevery 88 ms with each packet having 16, 8, and 2 data points,respectively. The communications module 110 stores these data packets asthese packets are received and, if necessary, the communications module110 arranges them in order prior to storing the data packets in thestorage 115.

In at least one embodiment, the communications module 110 is in astandby state until it receives a numeric heart rate value greater than10 beats per minute or between 10 and 350 beats per minute and ends asession when no such value is received for a 5-minute interval (althoughother time periods may be used), for example, any length of time in arange of 2 to 15 minutes (including the end points). The end of thesession in at least one embodiment is based on a predetermined thresholdof length of time (predetermined time threshold) of receipt values lessthan 10 beats per minute (predetermined vital-sign threshold). Therequirement for a heart rate value indicative of life provides areasonable basis to assume that the vital-sign monitor 190 is attachedto a person. However, in alternative embodiments, another vital-signsuch as SpO₂ is used to determine whether a patient is connected to thevital-sign monitor. In a further embodiment, a signal representing thata patient is connected or other status indication such as a “fault”state from ECG leads being cleared is provided by the vital-sign monitor190 to the communications module 110 to indicate when a session hasstarted and/or ended. The end condition reflects the case where thevital-sign monitor 190 is turned off or simply detached from the patientat the end of a medical session such as arrival at a medical facility.It is estimated that a one-hour session will require approximately 5 MBof disk space. In this embodiment, once the communications module 110detects the start of a session, then it notifies and/or activates theanalysis controller 120 and/or the test module 125 to start.

In a further embodiment, the communications module 110 timestamps thevital-sign information as part of storing the information into storage115. The timestamp allows for improved archival of the information andfor review of the information outputted by the test module 125, which inat least one embodiment allows for further refinement of thealgorithm(s) 1254 operating in the test module 125.

The storage 115 in at least one embodiment is computer storage medium asdefined later in this disclosure. An illustrative example of the storage115 is a memory. Based on this disclosure, it should be appreciated thatstorage 115 also includes a plurality of discrete storages for thedifferent data being stored in the system.

The analysis controller 120 monitors the physiological data logged intothe storage 115 for the presence of new data in at least one embodiment.When new data are detected and/or a new session started, the analysiscontroller 120 pushes that data to the test module 125 by extracting theinformation from storage 115 and providing it in an appropriate syntaxfor use by the algorithm(s) 1254 operating in the test module 125.

In at least one embodiment, the analysis controller 120 converts thepacket data into multiple constant-frequency row vectors. The vector inat least one embodiment has a length equal to the frequency multipliedby the time period (e.g., the example below has a vector length of 4).The analysis controller 120 aligns and/or shifts the data contained inthe storage 115 to take into account any communication breaks and/ormissing data. For example if the storage 115 contains the following datawhere Seq represents the packet number (or sequence):

-   Time=0, Seq=100, Data=[HR: 80, SaO₂: 98]-   Time=1, Seq=101, Data=[HR: 82]-   Time=3, Seq=103, Data=[HR: 81, SaO₂: 97]    The analysis controller 120 converts the information into two    vectors (one for heart rate (HR) and one for oxygen saturation    (SaO₂)):-   HR=[80 82 NaN 81]-   SaO₂=[98 NaN NaN 97]    where NaN (Not a Number) is representative of missing data, which in    this example Sequence 101 was missing SaO₂ and Sequence 102 was    missing in its entirety (or lost). The missing data was filled in    with NaNs (although other fillers could be used to indicate the    missing data) to preserve a frequency of 1 Hz for the data.

In an example where the sampling by the analysis controller 120 is tooccur at 5 seconds, but the packet (Sequence 104) has not been stored inthe storage 115. The analysis controller 120 in at least one embodimentincludes a time threshold beyond which it will consider the packet to belost.

In at least one embodiment, the analysis controller 120 pushes the databased on a predetermined sampling period to reduce the load on the testmodule 125 based on the algorithms being run in the test module 125. Forexample, in at least one embodiment, the analysis controller 120retrieves the current data every 5 seconds although the algorithm(s)1254 running in the test module 125 uses data at approximately 2 minuteintervals. In at least one embodiment, the analysis controller 120 isimplemented as a processor programmed with a configurable shell.

The test module 125 hosts and runs at least one algorithm with examplesof the algorithms including but not limited to the following functions:pattern recognition, generation of graphical displays, generation oftext files, determination of data quality, prediction of patient outcomeusing for example artificial intelligence classifiers, analysis oftime-series vital-sign data, etc. In at least one embodiment, the testmodule 125 includes running means 1252 for running the algorithm(s) 1254such as a software environment running on a processor in which the codeused to write the algorithm(s) is capable of functioning and interactingwith the vital-sign information provided to it by the test module 125.The test module 125 retrieves at least one algorithm 1254 from storage115 and runs it in response to data received from the analysiscontroller 120. In at least one embodiment, the analysis controller 120and/or test module 125 restrict the frequency of data provided to thealgorithm(s) 1254 to reflect the processing time required for thealgorithm(s) 1254, which results in data being provided at predeterminedtime intervals with some data being ignored with the most recent valuesbeing used at the predetermined time intervals. By retrieving thealgorithm(s) 1254 from storage 115, it allows for the algorithm(s) 1254to be updated, modified, or changed by loading into the storage 115 thenew/modified algorithm making it available for the next session.

The result produced by the algorithm(s) 1254 is provided by the testmodule 125 to at least one of the storage 115, the display 130, and anexternal device (not shown). In at least one embodiment, there are atleast two algorithms running with the first algorithm reviewing thevital-sign information for quality control and providing a filteredoutput of the vital signs that pass quality control to the second ormore algorithms running in the test module 125.

In at least one embodiment, the data placed into storage 115 isorganized by session, which as used in this disclosure means a timeperiod from when a patient is connected to a vital-sign monitor to thetime that they are disconnected for a period longer than thepredetermined time threshold discussed above from the vital-signmonitor.

The algorithms 1254 that are tested, evaluated and/or used in theabove-described embodiments will need to use the data syntax used by theanalysis controller 120. In at least one embodiment, the algorithm(s)1254 will have as its respective input(s) at least a portion of thevital signs in a form that will be able to communicate with the analysiscontroller 120. In at least one embodiment, the test module 125 willdiscard vital signs not of interest to the algorithm(s) 1254; however,in other embodiments the test module 125 provides all vital signsreceived from the analysis controller 120 to the algorithm(s) 1254 withthe algorithm(s) 1254 deciding what data it wants to use. In at leastone embodiment, the test module 125 and the algorithm(s) 1254 are builtusing the same computer language or code such as MATLAB, C, or LabVIEW.In at least one embodiment, the test module 125 is a processor executingsoftware to perform the functions described for the test module 125.

FIG. 3 illustrates an example of an embodiment built according to theinvention attached to a vital-sign monitor 190 such as the Propaq Encoresold by Welch Allyn although other vital-sign monitors could be usedinstead. There are a variety of ways for the system to communicate witha vital-sign monitor including but not limited to wireless or wired,such as a RS-232/USB cable adaptor or RS-232/serial cable adaptor 192.Based on this disclosure, it should be appreciated that there are avariety of additional ways that a vital-sign monitor 190 can beconnected to the system besides the illustrated connector. FIG. 3 alsoillustrates an embodiment of the system including a display 130 and ahousing 105 with a connector 1052. The illustrated system 100 was builtwith a test module 125 using MATLAB.

FIG. 4 illustrates a flowchart of a method embodiment according to theinvention for using the system illustrated in FIG. 2. The illustratedmethod in at least one embodiment is for operation of at least oneprocessor in a compact computer or a ruggedized, compact computer. In atleast one embodiment prior to initiation of a session, the computerreceives at least one algorithm into storage 115, 405. The algorithm(s)1254 will be used by the test module 125 during a session. In at leastone embodiment, the method includes detecting with the communicationsmodule 110 the initiation of a vital-sign monitoring session, 410. Thecommunications module 110 receives and stores the vital-sign informationinto storage 115, 415. As discussed above in at least one embodiment,the analysis controller 120 retrieves the vital-sign information fromstorage 115 and pushes the vital-sign information to the test module 125running the stored at least one decision-support algorithm 1254, 420.The test module 125 provides at least one output from thedecision-support algorithm 1254 to at least one of a database 115 and adisplay 130, 425, or in an alternative embodiment to an external deviceby for example wireless transmission through an antenna 1054 of theoutput. In a further embodiment, the test module 125 outputs an audiblealert when the algorithm(s) 1254 detects a critical condition or otherpredetermined situation. In a still further embodiment, the test module125 retrieves the stored decision-support algorithm(s) 1254 from storage115 after a session is initiated; or alternatively, the decision-supportalgorithm(s) 1254 is available in the test module 125 once received instorage 115.

In at least one embodiment, after multiple sessions are stored by thesystem, the stored data are transferred from the system for analysis andevaluation to determine whether the stored algorithm has functioned asintended and/or whether improvements should be made to the storedalgorithm.

In at least one embodiment, the information captured by the system isstored or copied to a computer storage medium capable of removable formthe system for transfer to the medical facility where the patient hasbeen taken. Alternatively, this information is transmitted wirelessly tothe medical facility.

FIG. 5 illustrates another embodiment according to the invention thatadds a reliability (or preliminary data analysis) module 122 to theembodiment illustrated in FIG. 2. In a further embodiment, thereliability module 122 is combined with the analysis controller 120. Ina further embodiment, the reliability module 122 is a module that isincluded in the test module 125 as another sub-module working inconjunction with the running means 1252 or as a quality control modulediscussed previously. In a further embodiment to any of the otherembodiments, the reliability module 122 includes a library of modules toallow for better testing of the algorithm 1254 where each module isassociated with at least one vital-sign reading. The reliability module122 reviews the data provided by the analysis controller 120 to the testmodule 125 as part of a preliminary computation on the vital-sign dataprior to use by the test module 125. In at least one embodiment, thereliability module 122 provides functionality that is important to awide-range of different decision-support algorithms.

After the vital-sign information is acquired, the analysis controller120 pushes the vital-sign information to the reliability module 122,which subsequently automatically determines when the vital-signinformation appears to be accurately measured and/or likewise when thevital-sign information appears to be unreliable due to a measurementerror. The determination of accuracy is made based on mathematicalanalysis of the vital-sign information performed on the vital-signinformation over time. In at least one embodiment, the mathematicalanalysis employs methods that classify the vital-sign information on thebasis of shapes as represented by a curve fit of the vital-signinformation and/or the rhythmic and cleanness of waveforms that appearin the data time-series, periodicity of shapes that are identified inthe data time-series, and on the degree of agreement between differentmathematical algorithms that compute properties of the vital-signinformation. In at least one embodiment, the decision-support algorithm1254 being tested renders its computational decision on the basis of thevital-signs information that was determined to be reliable by thereliability module 122.

In a further embodiment, the reliability module 122 uses information fora second and/or third vital-sign to determine whether the informationfor the first vital-sign is reliable. For example, if two vital-signsare known to increase together or decrease together in patients, andwhen the vital-sign information for these two vital-signs are checkedthere is one increasing and one decreasing, then the reliability module122 would identify both vital-signs as being potentially flawed. In afurther embodiment, an additional check of both vital-signs informationwould be done to determine which of the two is flawed. Another exampleis if there are two sensors reading the same vital-sign, then when thevital-sign information from these two sensors disagrees and/or diverges,then it will be determined that one of the sensors is producing flawedvital-sign information.

The previous two paragraphs provide examples of means for determiningwhether the vital-sign data is quality vital-sign data where quality isdefined as being sufficiently clean (or free) of noise and/or inagreement with at least one other vital-sign being monitored. In atleast one embodiment, the quality means is a processor programmed toperform the analysis to determine whether the vital-sign informationincludes quality information.

In a further embodiment, a user of the system can readily adjust thefunctionality of the reliability module by, for example, adjusting thecriteria for determining which vital-sign information is reliable can bemade increasingly stringent or increasingly lenient.

As will be appreciated by one skilled in the art based on thisdisclosure, aspects of the present invention may be embodied as asystem, method or computer program product. Accordingly, aspects of thepresent invention may take the form of an entirely hardware embodiment,a processor operating (or programmed) with a software embodiment(including firmware, resident software, micro-code, etc.) or anembodiment combining software and hardware aspects that may allgenerally be referred to herein as a “circuit,” “module” or “system.”Furthermore, aspects of the present invention may take the form of acomputer program product embodied in one or more computer readablemedium(s) having computer readable program code embodied thereon.

Any combination of one or more computer readable medium(s) may beutilized. The computer readable medium may be a computer readablestorage medium. A computer readable storage medium may be, for example,but not limited to, an electronic, magnetic, optical, electromagnetic,infrared, or semiconductor system, apparatus, or device, or any suitablecombination of the foregoing. More specific examples (a non-exhaustivelist) of the computer readable storage medium would include thefollowing: a portable computer diskette, a hard disk, a random accessmemory (RAM), a read-only memory (ROM), an erasable programmableread-only memory (EPROM or Flash memory), an optical fiber, a portablecompact disc read-only memory (CD-ROM), an optical storage device, amagnetic storage device, or any suitable combination of the foregoing.In the context of this disclosure, a computer readable storage medium isany tangible medium that can contain, or store, a program for use by orin connection with an instruction execution system, apparatus, ordevice. The above examples of computer readable storage medium are alsoexamples of the storage of the above discussed embodiments.

Computer program code for carrying out operations for aspects of thepresent invention may be written in any combination of one or moreprogramming languages, including an object oriented programming languagesuch as MATLAB, Java, Smalltalk, C++, C#, Python, or the like andconventional procedural programming languages, such as the “C”programming language or similar programming languages. The program codein at least one embodiment executes entirely on the compact, portablecomputer as a stand-alone software package.

The flowchart and block diagrams in the Figures illustrate thearchitecture, functionality, and operation of possible implementationsof systems, methods and computer program products according to variousembodiments of the present invention. In this regard, each block in theflowchart or block diagrams may represent a module, segment, or portionof code, which comprises one or more executable instructions forimplementing the specified logical function(s) on at least oneprocessor. It should also be noted that, in some alternativeimplementations, the functions noted in the block may occur out of theorder noted in the figures. For example, two blocks shown in successionmay, in fact, be executed substantially concurrently, or the blocks maysometimes be executed in the reverse order, depending upon thefunctionality involved. It will also be noted that each block of theblock diagrams and/or flowchart illustration, and combinations orsubcombinations of blocks in the block diagrams and/or flowchartillustration, can be implemented by special purpose hardware-basedsystems that perform the specified functions or acts, or combinations ofspecial purpose hardware and computer instructions. These computerprogram instructions may be provided to a processor of a general purposecomputer, special purpose computer, or other programmable dataprocessing apparatus to produce a machine, such that the instructions,which execute with the processor of the computer or other programmabledata processing apparatus, create means for implementing thefunctions/acts specified in the flowchart and/or block diagram block orblocks.

FIG. 6 illustrates an example hardware environment for practicing atleast one embodiment of the invention. This schematic drawingillustrates a hardware configuration of an information handling/computersystem in accordance with at least one embodiment of the invention. Thesystem includes at least one processor or central processing unit (CPU)610. The CPUs 610 are interconnected with a system bus 612 to variousdevices such as a random access memory (RAM) 614, a read-only memory(ROM) 616, and an input/output (I/O) adapter 618. The I/O adapter 618can connect to peripheral devices, such as disk units 611 and tapedrives 613, or other program storage devices that are readable by thesystem. The system can read the inventive instructions on the programstorage devices and follow these instructions to execute the methodologyof at least one embodiment of the invention. The system further includesa user interface adapter 619 that connects a keyboard 615, a mouse 617,a speaker 624, a microphone 622, and/or other user interface devicessuch as a touch screen device (not shown) to the bus 612 to gather userinput. Additionally, a communication adapter 620 connects the bus 612 toa data processing network 625, and a display adapter 621 connects thebus 612 to a display device 623, which may be embodied as an outputdevice such as a monitor, printer, or transmitter, for example.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a”, “an” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the root terms “include”and/or “have,” when used in this specification, specify the presence ofstated features, integers, steps, operations, elements, and/orcomponents, but do not preclude the presence or addition of one or moreother features, integers, steps, operations, elements, components,and/or groups thereof.

The corresponding structures, materials, acts, and equivalents of allmeans plus function elements in the claims below are intended to includeany structure, or material, for performing the function in combinationwith other claimed elements as specifically claimed. The description ofthe present invention has been presented for purposes of illustrationand description, but is not intended to be exhaustive or limited to theinvention in the form disclosed. Many modifications and variations willbe apparent to those of ordinary skill in the art without departing fromthe scope and spirit of the invention. The embodiments were chosen anddescribed in order to best explain the principles of the invention andthe practical application, and to enable others of ordinary skill in theart to understand the invention for various embodiments with variousmodifications as are suited to the particular use contemplated.

As used above “substantially,” “generally,” and other words of degreeare relative modifiers intended to indicate permissible variation fromthe characteristic so modified. It is not intended to be limited to theabsolute value or characteristic which it modifies but rather possessingmore of the physical or functional characteristic than its opposite, andpreferably, approaching or approximating such a physical or functionalcharacteristic.

Those skilled in the art will appreciate that various adaptations andmodifications of the embodiments described above can be configuredwithout departing from the scope and spirit of the invention. Therefore,it is to be understood that, within the scope of the appended claims,the invention may be practiced other than as specifically describedherein.

We claim:
 1. A method for testing decision-support algorithmscomprising: receiving into a storage of a ruggedized, compact computerat least one decision-support algorithm; receiving and storingvital-sign information associated with a vital-sign monitoring sessioninto the storage by a communications module; determining whether thevital-sign information is quality vital-sign information, when thevital-sign information is not quality vital-sign information then notusing that vital-sign information; pushing the stored quality vital-signinformation by an analysis controller to a test module running thestored at least one decision-support algorithm, wherein pushing includesretrieving the vital-sign information from the storage, and convertingthe vital-sign information into multiple constant-frequency row vectors;and providing at least one output from the decision-support algorithm toat least one of a database and a display.
 2. The method according toclaim 1, further comprising receiving the decision-support algorithminto the test module.
 3. The method according to claim 1, whereinconverting includes shifting data contained in the vital-signinformation to leave gaps representing missing data.
 4. The methodaccording to claim 1, wherein the storage includes capacity for storinga plurality of decision-support algorithms, and the storage allows forquick exchange of stored decision-support algorithms.
 5. The methodaccording to claim 1, further comprising detecting with thecommunications module an initiation of the vital-sign monitoringsession.
 6. The method according to claim 5, further comprisingdetermining when the vital-sign monitoring session has ended based on atleast one of a vital-sign being less than a predetermined vital-signthreshold and a signal representing an end of the vital-sign monitoringsession received from a source of the vital-sign information, andwherein detecting the initiation of the vital-sign monitoring is basedon at least one of a vital-sign being above the predetermined vital-signthreshold and a signal representing a start of the vital-sign monitoringsession received from the source of the vital-sign information.
 7. Amethod for testing decision-support algorithms comprising: receivinginto a storage of a ruggedized, compact computer at least onedecision-support algorithm; receiving and storing vital-sign informationassociated with the vital-sign monitoring session into the storage by acommunications module; detecting with the communications module aninitiation of a vital-sign monitoring session; determining whether thevital-sign information is quality vital-sign information, when thevital-sign information is not quality vital-sign information then notusing that vital-sign information; pushing the stored quality vital-signinformation by an analysis controller to a test module running thestored at least one decision-support algorithm; providing at least oneoutput from the decision-support algorithm to at least one of a databaseand a display; and detecting when the vital-sign monitoring sessionterminates based on a received heart beats per minute being less than 10heart beats per minute for a predetermined time threshold, and whereindetecting the initiation of the vital-sign monitoring includes detectinga heart beat per minute in excess of 10 heart beats per minute.
 8. Amethod for testing decision-support algorithms comprising: receivinginto a storage of a computer at least one decision-support algorithm;receiving and storing vital-sign information associated with avital-sign monitoring session into the storage by a communicationsmodule; pushing the stored vital-sign information by an analysiscontroller to a test module running at least one of the stored at leastone decision-support algorithm, wherein pushing includes retrieving thevital-sign information from the storage, and converting the vital-signinformation into multiple constant-frequency row vectors; and providingat least one output from the decision-support algorithm to at least oneof a database and a display.
 9. The method according to claim 8, whereinconverting includes shifting data contained in the vital-signinformation to leave gaps representing missing data.
 10. The methodaccording to claim 8, where the vital-sign information is received bythe communications module from a vital-sign monitor; and wherein thecomputer is ruggedized and compact.
 11. The method according to claim10, further comprising loading at least one decision-support algorithminto the test module.
 12. The method according to claim 10, whereinconverting includes shifting data contained in the vital-signinformation to leave gaps representing missing data.
 13. The methodaccording to claim 10, further comprising determining whether thevital-sign information is quality vital-sign information, when thevital-sign information is not quality vital-sign information then notusing that vital-sign information.
 14. The method according to claim 10,further comprising detecting with the communications module aninitiation of the vital-sign monitoring session.
 15. The methodaccording to claim 14, further comprising determining when thevital-sign monitoring session has ended based on at least one of avital-sign being less than a predetermined vital-sign threshold and asignal representing an end of the vital-sign monitoring session receivedfrom the vital-sign monitor, and wherein detecting the initiation of thevital-sign monitoring is based on at least one of a vital-sign beingabove the predetermined vital-sign threshold and a signal representing astart of the vital-sign monitoring session received from the vital-signmonitor.
 16. The method according to claim 8, further comprisingdetecting with the communications module an initiation of the vital-signmonitoring session.
 17. The method according to claim 16, furthercomprising determining when the vital-sign monitoring session has endedbased on at least one of a vital-sign being less than a predeterminedvital-sign threshold and a signal representing an end of the vital-signmonitoring session received from a source of the vital-sign information,and wherein detecting the initiation of the vital-sign monitoring isbased on at least one of a vital-sign being above the predeterminedvital-sign threshold and a signal representing a start of the vital-signmonitoring session received from the source of the vital-signinformation.